QuadMed offers a program for pregnant associates and covered dependents designed to help the mother and baby stay healthy during pregnancy and in the days and weeks after the baby is born. For details on the program, please refer to the Expectant Mothers Program Brochure.

Q.

How do I (or my spouse) participate in the Expectant Mothers Program?

A.

To enroll in QuadMed's Expectant Mothers Program, simply call the QuadMed Wellness Coordinator at 706-532-6705 as soon as you or your spouse know you are pregnant.

Q.

Is there an incentive for participating in the Expectant Mothers Program?

A.

Once the program is completed, enrollments made by the end of the first trimester will receive a $400 HSA deposit and enrollments made by the end of the second trimester will receive a $200 HSA deposit.

I went to the doctor for an annual physical and I was charged for some services during my visit. What can I do to ensure my annual physical visit is covered at 100%?

A.

You must talk with your physician to make sure they are coding your visit as “preventative”. If a service during your annual physical is coded as “diagnostic”, then it would be eligible for coverage as any other medical service (not at 100%).

Q.

Do I have to wait at least one full year to schedule my next annual physical?

A.

No, one annual physical in a calendar year is eligible to be covered under the Shaw Medical Plan. For example, if you had your annual physical in March 2016, you could have your annual physical in February 2017 and that would fall under the benefits of the Plan. Some physicians prefer to wait one full year (from date of service to date of service) before they will schedule an annual physical, but that is not a Plan requirement.

How do I find out more about the WellYou programs for Diabetes, Asthma, and High Blood Pressure?

A.

Shaw offers WellYou programs for Diabetes, Asthma, and High Blood Pressure through QuadMed. See the WellYou brochure for more information. Program enrollment can be completed at any time with the WellYou enrollment packet.

Q.

How do I enroll in the Well You Programs through QuadMed?

A.

Enrollment for QuadMed's Well You Programs can be completed at any time. You may see your Occupational Health Nurse to complete the enrollment forms for this program or click here for the enrollment packet.

Q.

Can my spouse and/or dependents participate in the Well You programs?

A.

Yes, covered spouses and dependents are eligible to enroll in QuadMed's Well You Programs. Click here for the enrollment packet.

Q.

What are the incentives for participating in the Well You Programs?

A.

All programs (Diabetes, Asthma and High Blood Pressure) will provide zero member cost for prescription drugs on the Express Scripts Preventive List for each condition (no deductible). Also, educational opportunities are available through unlimited access to your Well You team of educators.

Q.

In the Well You Program for Diabetes, what is covered under "Diabetic Medications and Supplies"?

A.

The Well You Program for Diabetes will provide zero member cost for prescription drugs on the Express Scripts Preventive List for diabetes (no deductible).

Diabetic medications and supplies filled through the prescription plan are covered with the $0 member cost at the pharmacy or home delivery order when enrolled in the Shaw Medical plan. Durable medical equipment, such as insulin pumps and supplies, diabetic shoes, and diabetic monitors, would be billed under the medical plan instead of at the pharmacy and as a result are not eligible for coverage under this program.

Q.

What do I have to do to remain in the Well You Programs each year?

A.

Below is the annual compliance for QuadMed's Well You Programs:

Q.

When do the Well You Program requirements have to be completed?

A.

Program compliance will be tracked for each enrolled condition when the anniversary date of each enrolled condition is approaching. Compliance reviews will be done throughout the year to help you stay on track.